OBJECTIVES: Analyze and evaluate the impact of community health workers (CHW) in increasing colorectal cancer (CRC) screening for Black men. Secondly, to encourage private payers’ investment in robust screening programs that will reduce medium-to long-term costs, improve outcomes, and decrease racial disparities in CRC mortality.

METHODS: We performed a scoping search in PubMed, using: “colorectal cancer screening”, “racial disparities”, “outcomes”, “cost-effectiveness”, and “community health workers”. Search was limited to publications in the last 10 years in English. Prevalence and cost data were collected from the Centers for Disease Control and Prevention website. CRC-screening costs, care for the disease, and implementation of a CHW program were collected from these sources.

RESULTS: 81 articles were reviewed, and 18 were included. The CRC rate per 100,000 White (WM) and Black (BM) men was 47.5/40.7; The mortality was 21.3/15.5, 1.3-fold higher among BM than WM. Black people were four times more likely to be diagnosed at advanced stages, incurring greater treatment and societal costs.

Medicare covers two-thirds of CRC treatments, leaving one-third to private payers or Medicaid. In 2018, only 66.0% BM and 69.5% WM were up-to-date with recommended screenings despite screening being a cost-effective prevention. People covered by private insurance were only 61% up-to-date.

CHW collaboration with providers and payers has been shown to be a cost-effective way to increase screening uptake for other conditions across the United States. CHWs have greater economic impact when addressing preventable health issues than managing advanced diseases and the cost of these programs is low.

CONCLUSIONS: Integrating CHWs into existing healthcare systems is shown to be cost-effective and a sustainable way to expand access to health services and reduce racial disparities in outcomes. Funding CHWs programs that increase CRC screening among Black men is potentially cost-effective and could reduce racial disparities in outcomes.

ISPOR 2022

May 15-18, 2022

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